Heart group urges "hands-only" CPR in emergencies

Reuters March 31, 2008

Will Dunham

Bystanders who see someone suddenly collapse should quickly give the person chest compressions even if they are not trained in cardiopulmonary resuscitation, the American Heart Association said on Monday.

The association urged people not to stand idly by because they do not think they know how to administer CPR while an adult stricken with sudden cardiac arrest is dying in front of them.

In recommendations published in its journal Circulation, the group emphasized "hands-only" CPR -- a simple procedure that bystanders can perform without worrying about doing the mouth-to-mouth resuscitation part of CPR.

"The thing that's killing people is inaction," said Dr. Michael Sayre of Ohio State University, who headed the association's team that drafted the new recommendations.

Sayre said people not trained in CPR should do two things when they encounter an adult who has suddenly collapsed: first, call emergency services; and second, begin pushing "hard and fast" in the center of the person's chest.

This is necessary to maintain vital blood flow, according to experts. Chest compressions should continue until emergency medical services responders arrive, Sayre said.

"Today in the United States, less than a third of victims of sudden cardiac arrest get any form of CPR. Anything that would increase that is bound to save lives," Sayre said in a telephone interview.

"We want the general public to know that even if they've never been trained, they can help victims of sudden cardiac arrest."

In the minutes after an adult collapses, hands-only CPR -- without mouth-to-mouth rescue efforts -- is equivalent to conventional CPR in its life-saving value, Sayre said.

All too often, no one at the scene does anything to help the victim of sudden cardiac arrest -- often because there is no one trained in CPR and other people are scared that they will do something to make the victim's condition worse.

But considering the person's condition, Sayre said, "You can't make them any worse."

The heart association said that about 310,000 adults in the United States die annually from sudden cardiac arrest that takes place away from a hospital setting. It said that CPR administered by a bystander can double or triple a person's chance of surviving.

About 94 percent of sudden cardiac arrest victims die before reaching a hospital, the group said. Up to 80 percent of sudden cardiac arrests occur at home, it added. Brain death begins four to six minutes after a person suffers sudden cardiac arrest if no CPR or defibrillation is given.

"Hands-only" CPR is not advised for babies and children or for adults whose cardiac arrest is due to respiratory causes such as a drowning scenario or drug overdose, the group said.

The new recommendations update the group's 2005 advice that had asked bystanders to do chest compressions only if they were unable or unwilling to provide mouth-to-mouth efforts.

Conventional CPR is still an crucial skill to know and medical personnel should still perform it, the group said.